Seasonal Variation in Direct Obstetric Mortality in Rural Senegal: Role of Malaria?

Étard, Jean-François; Kodio, B.; Ronsmans, Carine

doi:10.4269/ajtmh.2003.68.503

Cited by 35 publications

(27 citation statements)

References 8 publications

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“…Findings in other countries in western Africa 21,22 similar to those reported above for Rwanda reinforce the message that malaria can have a significant impact on maternal mortality during the rainy season. In addition, McCawBinns et al 23 report data from Jamaica on an increase in HIV/AIDS-related maternal deaths that was associated with a rise in indirect maternal deaths overall while direct obstetric deaths were decreasing.…”

Section: Discussionsupporting

confidence: 75%

What you count is what you target: the implications of maternal death classification for tracking progress towards reducing maternal mortality in developing countries

Cross¹,

Bell²,

Graham³

2010

Bull World Health Org

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The first target of the fifth United Nations Millennium Development Goal is to reduce maternal mortality by 75% between 1990 and 2015. This target is critically off track. Despite difficulties inherent in measuring maternal mortality, interventions aimed at reducing it must be monitored and evaluated to determine the most effective strategies in different contexts. In some contexts, the direct causes of maternal death, such as haemorrhage and sepsis, predominate and can be tackled effectively through providing access to skilled birth attendance and emergency obstetric care. In others, indirect causes of maternal death, such as HIV/AIDS and malaria, make a significant contribution and require alternative interventions. Methods of planning and evaluating maternal health interventions that do not differentiate between direct and indirect maternal deaths may lead to unrealistic expectations of effectiveness or mask progress in tackling specific causes. Furthermore, the need for additional or alternative interventions to tackle the causes of indirect maternal death may not be recognized if all-cause maternal death is used as the sole outcome indicator. This article illustrates the importance of differentiating between direct and indirect maternal deaths by analysing historical data from England and Wales and contemporary data from Ghana, Rwanda and South Africa. The principal aim of the paper is to highlight the need to differentiate deaths in this way when evaluating maternal mortality, particularly when judging progress towards the fifth Millennium Development Goal. It is recommended that the potential effect of maternity services failing to take indirect maternal deaths into account should be modelled.Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬

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Section: Discussionsupporting

confidence: 75%

What you count is what you target: the implications of maternal death classification for tracking progress towards reducing maternal mortality in developing countries

Cross¹,

Bell²,

Graham³

2010

Bull World Health Org

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“…There are epidemiologic similarities between PAM and preeclampsia, both being more frequent in primigravidae [36], and a major cause of maternal mortality in developing countries [36, 37]. Some authors described similar seasonal changes in the incidence of both preeclampsia and PAM, with increased incidence during the rainy season [38, 39]. Clinically, reduced placental perfusion is a common link between these pathologies that are associated with fetal growth restriction [10, 40].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of a biomarker to identify placental dysfunction in the context of malaria

Gueneuc

Deloron

Bertin

2017

Malar J

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In most tropical areas, pregnant women are at increased risk of malaria, as a consequence of the massive sequestration of parasitized red blood cells in the placenta. The placenta plays a key role in embryonic and fetal development as well as in maternal-fetal exchanges, and pregnancy-associated malaria may alter selected placenta functions that lead to stillbirth and low birth weight. Although there are several tools (blood smear examination, RDT, PCR) to diagnose malaria infection during pregnancy, there is currently no test to assess placenta dysfunction in the framework of pregnancy-associated malaria. Pregnancy-associated malaria shares many features with preeclampsia, an extensively studied disease. Various biomarkers associated with placental dysfunction have been identified as associated with preeclampsia. Several of these are inflammatory markers that lack of specificity. A few seem more specific of placenta dysfunction, including s-endoglin and sFlt1, increased in the peripheral blood during preeclampsia. The predictive value of these biomarkers should be studied in the context of pregnancy-associated malaria to evaluate their usefulness in identifying placental dysfunction during malaria. These biomarkers should be considered to improve the diagnosis of placental dysfunction during malaria and pregnant women monitoring.

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“…The authors further attributed the preeclampsia to ischemia of the placental tissue, which results in macrophages, augmented number of interveillous fibrin and condensed trophoblastic lamina resulting in poor placental blood circulation. Etard et al (2003), found that women with preeclampsia in Senegal had increased risk of placental malaria, compared to those without pre-eclampsia and that the risk coincided with the rainy season. Similarly, Adam et al (2011) established that placental malaria is associated with preeclampsia.…”

Section: Discussionmentioning

confidence: 96%

“…Verhoeff et al (1999), Obed et al (1994), Bouvier et al (1997) administered questionnaires, while four studies (Verhoeff et al, 1999;Bondevik et al, 2000;Fleming, 1970;Bouvier et al, 1997) examined hematocrit levels, necessitating blood samples. Finally, Etard et al (2003) interviewed the relatives of deceased women to inquire about the circumstances of death; this is known as the "sisterhood method".…”

Section: Study Designsmentioning

confidence: 99%

Association of anemia, pre-eclampsia and eclampsia with seasonality: A realist systematic review

Hlimi

2015

Health & Place

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Seasonal Variation in Direct Obstetric Mortality in Rural Senegal: Role of Malaria?

Cited by 35 publications

References 8 publications

What you count is what you target: the implications of maternal death classification for tracking progress towards reducing maternal mortality in developing countries

What you count is what you target: the implications of maternal death classification for tracking progress towards reducing maternal mortality in developing countries

Usefulness of a biomarker to identify placental dysfunction in the context of malaria

Association of anemia, pre-eclampsia and eclampsia with seasonality: A realist systematic review

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